Review Effectiveness and cost-effectiveness of non-pharmacological interventions for functional somatic disorders: Systematic review... 2025 Boluda-Verdú+

[Andy]

Full title: Effectiveness and cost-effectiveness of non-pharmacological interventions for functional somatic disorders: systematic review of meta-analyses and economic evaluations

Abstract

Objective
To analyze the effectiveness and cost-effectiveness of non-pharmacological interventions for functional somatic disorders through a review of systematic reviews with meta-analysis and economic evaluations.

Method
Searches were carried out in PubMed/MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and PsycINFO (until June 2024). Outcome measures were improvement in symptoms (for systematic reviews) and incremental cost-effectiveness ratio (for economic evaluations). Methodological quality was assessed with AMSTAR-2 for systematic reviews and with QHES for economic evaluations. A narrative synthesis of the studies was performed, without meta-analysis. Protocol registration: Open Science Framework (https://osf.io/u3w2b/).

Results
32 studies were included (27 systematic reviews and 5 economic evaluations). All systematic reviews included randomized trials, except 2 that also included non-randomized studies. In systematic reviews, the most studied conditions were gastrointestinal disorders (12/27) and physical symptoms not explained by an organic pathology (6/27), while in economic evaluations they were undifferentiated somatoform disorders (2/5). The systematic reviews that included comparisons of psychological therapies, mindfulness and herbal medicine seemed to indicate improvements in symptoms. However, those systematic reviews that included acupuncture were inconclusive. All economic evaluations were associated with randomized trials. The incremental cost-effectiveness ratios were dominant (less costs, more effective) in 2 studies evaluating cognitive behavioral therapy. Of the systematic reviews, 20 presented critically low quality, 5 low quality and 2 moderate quality, while the 5 economic evaluations presented high quality.

Conclusions
The evidence on the effectiveness and cost-effectiveness of non-pharmacological interventions for functional somatic disorders should be interpreted with caution since the majority of the systematic reviews were of low or critically low methodological quality, and with a high level of uncertainty in the case of economic evaluations. The diversity of definitions of the diagnosis and interventions makes it difficult to generalize these results.

Open access (in Spanish)

 

[Utsikt]

through a review of systematic reviews with meta-analysis and economic evaluations.

the majority of the systematic reviews were of low or critically low methodological quality, and with a high level of uncertainty in the case of economic evaluations

So this is a review of the BPS reviews, and it found that they were all quite terrible?

 

[rvallee]

a review of systematic reviews

I'm gonna personally hold on for a review of reviews of reviews, thank you very much. We need to go one step further. And then another. You gotta find the final turtle, or else all of this is for nothing. Nothing! What happens if you find out that this last turtle is just hanging out there in space, with its legs just casually hanging out? Mayhem!

But of course within a few years they'll use a few more alternative labels and get on to brand new-identical pilot experimental studies and restart the cycle again, and again, and again. However long the rest of the profession is OK with letting this scam ruin millions of lives.

Of the systematic reviews, 20 presented critically low quality, 5 low quality and 2 moderate quality

Keeping in mind that they grade themselves on a very deliberate curve, those would normally be at least one, likely two, levels down, from critically misleading down to, at best, very low quality. Meanwhile the quality of the economic analyses doesn't matter since it's basically like dividing by zero.

But of course the very low quality isn't just a feature, it's a necessity. Without the low quality, it's exactly like Uri Geller not being able to use his own spoons: it's simply unfair to his shtick of using spoons made of a special alloy that, of course, only appear to bend when held between fingers, never on a surface of any other place.

But because of the hubris that dominates this industry, they would call it unfair if they had to do things fairly, let alone meeting the most basic scientific standards. Because it's a necessity for them to be dishonorable, otherwise they got nothing. Of course they will never produce anything of value, but as long as they are allowed to dishonorably pretend otherwise, well, they can dishonorably pretend otherwise and the rest of the industry can be complicit in forcing harmful pseudoscience down people's throats, and of never honestly accounting for the disastrous outcomes.

 

[Sean]

So, 74% of the studies are utter shit, 18% are shit, and less than 8% achieve a bare pass mark.

This is beyond pathetic. It is a profound and deeply entrenched systemic failure of the peer-review system in this area of medicine.

 

[bobbler]

Full title: Effectiveness and cost-effectiveness of non-pharmacological interventions for functional somatic disorders: systematic review of meta-analyses and economic evaluations

Abstract

Objective
To analyze the effectiveness and cost-effectiveness of non-pharmacological interventions for functional somatic disorders through a review of systematic reviews with meta-analysis and economic evaluations.

Method
Searches were carried out in PubMed/MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and PsycINFO (until June 2024). Outcome measures were improvement in symptoms (for systematic reviews) and incremental cost-effectiveness ratio (for economic evaluations). Methodological quality was assessed with AMSTAR-2 for systematic reviews and with QHES for economic evaluations. A narrative synthesis of the studies was performed, without meta-analysis. Protocol registration: Open Science Framework (https://osf.io/u3w2b/).

Results
32 studies were included (27 systematic reviews and 5 economic evaluations). All systematic reviews included randomized trials, except 2 that also included non-randomized studies. In systematic reviews, the most studied conditions were gastrointestinal disorders (12/27) and physical symptoms not explained by an organic pathology (6/27), while in economic evaluations they were undifferentiated somatoform disorders (2/5). The systematic reviews that included comparisons of psychological therapies, mindfulness and herbal medicine seemed to indicate improvements in symptoms. However, those systematic reviews that included acupuncture were inconclusive. All economic evaluations were associated with randomized trials. The incremental cost-effectiveness ratios were dominant (less costs, more effective) in 2 studies evaluating cognitive behavioral therapy. Of the systematic reviews, 20 presented critically low quality, 5 low quality and 2 moderate quality, while the 5 economic evaluations presented high quality.

Conclusions
The evidence on the effectiveness and cost-effectiveness of non-pharmacological interventions for functional somatic disorders should be interpreted with caution since the majority of the systematic reviews were of low or critically low methodological quality, and with a high level of uncertainty in the case of economic evaluations. The diversity of definitions of the diagnosis and interventions makes it difficult to generalize these results.

Open access (in Spanish)

Am I right in the last few lines confessing that basically ALL the research on effectiveness/ ie whether it works or us a big hoax harming patients but paying those doing it / ‘flawed’ as if accents in methodology

yet these people are still claiming ‘economic evaluations’ which are based on these can be high quality ? None sense - something useless or harmful is a WASTE of money at ANY PRICE


Looking at the current politics attacking those with Danilo ties in various countries on the basis of lines in the state benefit column

isn’t it about time someone started totalling up the total costs - including tenured ressarchers’ time - going on iteratively repeating crap methods on the same thing that hasn’t been proven other than the null in tens probably hundreds of thousands attempts sll with bias inbuilt and deliberately no null hypothesis so it can’t be proven once

is it the health budget line?
Or the university snd research line?

The sickening thing is I’ve a grim feeling there might be some simple treatment to fix me/cfs if caught before those who’ve had it so many years maybe get cumulative damage snd comorbidities

and these people are part of why such solutions aren’t being found

why is it that someone somewhere chose to create this issue of standing deliberately in the way of proper research to make such illness fixable in order to keep people ill?

I can only think of two good reasons from probably the same niche of people

and they aren’t pretty

 

[Utsikt]

Am I right in the last few lines confessing that basically ALL the research on effectiveness/ ie whether it works or us a big hoax harming patients but paying those doing it / ‘flawed’ as if accents in methodology

yet these people are still claiming ‘economic evaluations’ which are based on these can be high quality ? None sense - something useless or harmful is a WASTE of money at ANY PRICE

We know from NICE that all of the studies up until that point were of very low or low quality. This study finds that the reviews of those studies also were of very low or low quality.

Except for, as you point out, some of the economic analyses. But if the input in those analyses were of fatally low quality, the output will be the same.

So yes, the entire BPS-approach to ME/CFS is based on rubbish from end to end.

 

[Utsikt]

To be clear - they looked at more than ME/CFS. But they did not include the Larun review!